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Friary Fields Care Home Requires improvement


Inspection carried out on 18 July 2016

During a routine inspection

This inspection took place on 18 July 2016 and was unannounced.

Friary Fields Care Home provides accommodation for up to 34 older people and people living with dementia. 20 people were living at the service at the time of the inspection.

Friary Fields Care Home is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A registered manager was in place.

Improvements in the systems and processes to check the management of medicines were required. Protocols to advise staff about the administration of prescribed medicines to be taken as and when required were not available. Information about people’s preferences of how they took their medicines was not available for every person.

Staff were aware of their responsibilities to protect people from abuse and avoidable harm. Staff had received adult safeguarding training and had available the provider’s safeguarding policy and procedure.

Risks to people's individual needs and the environment had been assessed. Staff had information available about how to meet people’s needs, including action required to reduce and manage known risks. These were reviewed on regular basis. Accidents and incidents were recorded and appropriate action had been taken to reduce further risks. The internal environment was safe but action was required to ensure the external building was kept safe at all times.

Safe recruitment practices meant as far as possible only suitable staff were employed. Staff received an induction, training and appropriate support. There were sufficient experienced, skilled and trained staff available to meet people's individual needs.

People's healthcare needs had been assessed and were regularly monitored. The provider worked with healthcare professionals to ensure they provided an effective and responsive service. However, for one person staff had not followed recommendations from a healthcare professional and this had impacted on the person’s health.

People received sufficient to eat and drink and their nutritional needs had been assessed and planned for. People received a choice of meals and independence was promoted.

The registered manager applied the principles of the Mental Capacity Act 2005 (MCA) and Deprivations of Liberty Safeguards (DoLS), so that people's rights were protected. Where people lacked mental capacity to consent to specific decisions about their care and support, appropriate assessments and best interest decisions had been made in line with this legislation. However, these lacked specific details in places and had not been reviewed. Where there were concerns about restrictions on people’s freedom and liberty, the registered manager had appropriately applied to the supervisory body for further assessment.

Staff were kind, caring and respectful towards the people they supported. They had a person centred approach and a clear understanding of people's individual needs, routines and what was important to them.

The provider enabled people who used the service and their relatives or representatives to share their experience about the service provided.

People were involved as fully as possible in their care and support. There was a complaints policy and procedure available and people were confident to report any concerns or complaints to the registered manager. People had some information about external services that could provide support. The registered manager had information leaflets about independent advocacy services that they were going to make available for people.

People were supported to participate in activities, interests and hobbies of their choice. Staff promoted people’s independence.

The provider had checks in place that monitored the quality and safety of the service. These included daily, weekly and monthly audits.

Inspection carried out on 2 December 2013

During an inspection to make sure that the improvements required had been made

This inspection was carried out to follow up on our previous inspection in July 2013, where we found the provider was not compliant with two outcomes.

Prior to our visit we reviewed all the information we had received from the provider, including an action plan detailing how they would comply with the compliance action we set at the previous inspection. During the visit we spoke with a relative and asked them for their views. We also spoke with the registered manager, a senior care worker, two care workers and a housekeeper.

We looked at the prevention and control of infections policy and procedures and other records within the service, including three people’s care files. We also did a tour of the communal bathrooms and toilets.

A relative spoke highly of the care and support their relative had received whilst residing at the home.They told us the manager had responded very quickly to the request for a short term placement. Comments included, "I've been so impressed with the home, in my opinion the manager is really on the ball, they came to the hospital to do an assessment but not just about medical needs, they took the time and trouble to get to know my father as a person." And, "All the staff have been smashing in supporting my father, they are kind and caring. The care has been excellent."

We found the provider had made the required improvements to become compliant with these outcomes.

Inspection carried out on 31 July 2013

During a routine inspection

Prior to our inspection we reviewed all the information we had received from the provider. During the inspection we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke with two relatives for their views and spoke with four members of staff this included care staff and the cook. The registered manager was not available on the day of our inspection but we spoke with the provider (owner).

We also looked at service information, care plan files for four people and did a tour of the building.

The relatives we spoke with told us they felt communication was good with the registered manager and staff. They said they were consulted and involved in decisions about their relative’s needs. Comments included, “The manager is very approachable, and they listen to what you have to say, I feel involved in my husband’s care.”

We observed people being served their lunch and drinks throughout the day. We saw people were offered choices and the menu provided nutritional and well balanced meals.

We saw improvements had been made to the cleanliness of the home but we found further work was still required.

We observed staff who interacted with people constantly during the day. Staff appeared very knowledgeable, competent and experienced in supporting people with a dementia type illness.

We found some of the records used were not up to date or reflective of people’s needs.

Inspection carried out on 25 February 2013

During a routine inspection

Prior to our visit we reviewed all the information we had received from the provider. We used observation to help us understand the experiences of people using the service, because due to the communication needs of some people who used the service, they were not able to tell us their experiences.

We spoke with two people who used the service, three relatives and a visiting professional. We also spoke with the registered manager, four members of staff and looked at service information, records and carried out a tour of the building.

People told us they were treated with dignity and respect and their care needs were well met. One person told us, “I like living here; they (staff) are very good at their job.” Another person said, “I feel the staff involve me and listen to me.”

Relatives we spoke with told us they felt they were involved in their relatives care and treatment. Comments included, “Communication is very good, they (staff) are straight on the phone if they need to tell me something. I have the upmost respect for the staff.”

Relatives and a visiting professional we spoke with described the home as homely, warm and welcoming. They said staff were competent, experienced and knowledgeable. One person told us, “The staff are very friendly; they make me feel my mum is special. I know she (mum) is safe and well cared for.” Other comments included, “Whenever I visit there are always activities happening, staff interact really well with the residents.”

Inspection carried out on 6 March 2012

During a routine inspection

Some people living at Friary Fields Care Home had limited verbal communication and were not able to tell us about their experience of the service. Other people living at Friary Fields Care Home did not want to talk to us about their experience of the service. We therefore observed care, inspected care plans and the premises to evaluate the quality of support provided to people living at Friary Fields Care Home.

Reports under our old system of regulation (including those from before CQC was created)